Active NPI
Montezuma Family Dental
- General Practice Dentistry
- Lake Montezuma, AZ
National Provider Identifier
1992171532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- MONTEZUMA FAMILY DENTAL
- Practice address
- 4283 N Pima Way
Lake Montezuma, AZ 86342 - Phone
- (928) 202-4787
- Fax
- (928) 233-6904
- NPI assigned
- Aug 18, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ryan Carter, D.D.S
- Title
- Dentist
- Phone
- (928) 202-4787
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
4283 N Pima Way
Lake Montezuma, AZ 86342
Mailing address
PO Box 5682
Lake Montezuma, AZ 86342-5682
Phone (928) 202-4787
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439856000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1439856000000",
"number": "1992171532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5682",
"city": "LAKE MONTEZUMA",
"state": "AZ",
"postal_code": "863425682",
"telephone_number": "928-202-4787",
"fax_number": "928-233-6904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4283 N PIMA WAY",
"city": "LAKE MONTEZUMA",
"state": "AZ",
"postal_code": "86342",
"telephone_number": "928-202-4787",
"fax_number": "928-233-6904"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MONTEZUMA FAMILY DENTAL",
"organizational_subpart": "NO",
"enumeration_date": "2015-08-18",
"last_updated": "2015-08-18",
"status": "A",
"authorized_official_last_name": "CARTER",
"authorized_official_first_name": "RYAN",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "928-202-4787",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Montezuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.